The contrast between the “ideal” of the holiday and how we feel inside can be enormous, making the bad or painful feelings all the more pronounced.

“We feel guilty at this time of year if we personally cannot live up to the standard to be ever-cheerful and happy and joyful,” said Dr. Arthur Hayward, national clinical lead in elder care at Kaiser Permanente in Oakland, Calif.

Expectations for merriment and joy are high, Hayward said, as evidenced in holiday greeting cards.

We feel guilty at this time of year if we personally cannot live up to the standard to be ever-cheerful and happy and joyful.

— Dr. Arthur Hayward, Kaiser Permanente

“The wishes are not, ‘Have a pretty good Christmas’ or ‘Have an OK New Year,’ but ‘Have the best Christmas ever’ and ‘a very prosperous New Year,’” he said.

Different for Older Adults

For those who are still active, have children at home or have not yet retired, the holiday season can be a whirlwind of activity that feels draining.

Challenging in a different way may be the loneliness of older adults as friends die and family members move away. In a troubling survey from 2015, a quarter of those 65 and older in England said they were not looking forward to Christmas, and many of those said it was because “the festive season brings back too many memories of loved ones who have passed away,” according to a poll for the British nonprofit Age UK.

Two-thirds of the 1,793 older adults surveyed reported that loneliness is exacerbated by the holiday season.

Recognizing that many feel a heavier burden of grief this time of year, some places of worship hold “Blue Christmas” or similar services. December is also the month in which The Compassionate Friends, a group for people who have lost a child, holds candlelight ceremonies worldwide. The 2017 commemoration was held on Sunday, Dec. 10, and all were encouraged to light a candle at 7 p.m. local time.

The Blues or Depression?

The shorter days during winter can contribute to Seasonal Affective Disorder, or SAD. This malady is not just “the blues,” but a type of major depression, according to the Mayo Clinic. People who are depressed may feel sad, hopeless or worthless; lose interest in things they used to enjoy; sleep too much or too little; have trouble concentrating; have little energy; notice changes in their appetite or weight or have thoughts of dying or suicide, the Mayo Clinic says.

If you feel that you or a loved one are suffering from depression, it’s important to seek treatment, Hayward said.

As difficult as the holidays can be, Hayward offered some advice for coping:

Tips for Getting Through the Season

• Get plenty of rest. When you take care of your body, you will feel better.
• Try to keep your expectations of the holiday modest. That may help prevent feelings of disappointment or of being let down.
• Know that it is OK to feel sad or lonely. You don’t have to try to fake it to live up to the expectations of others.
• Spend time with friends and other people you enjoy. Do things you want to do, not just the things you have to do.
• It’s fine to say no sometimes. Wearing yourself out with too many activities will only make you feel worse.

Tips for Family or Friends

• Ask your depressed loved one to do things with you, such as go for a walk or to a movie. If he or she says no, that’s OK. But do ask again in the future.
• Ask how you can help in the person’s day-to-day life. You might do some housework, lawn care or errands.
• Get your loved one to talk about happy memories. This may help him or her feel more a part of the celebration.
• Listen when the person wants to talk. Don’t try to talk him or her out of sad feelings, but acknowledge them.